GLP-1 Therapy: Diabetes, Obesity Treatment & Impact in India

GLP-1 therapy, long used for diabetes management, has recently surged in popularity due to its expanded role in obesity and weight management.

• Patent expiry (March 2026): The patent of Novo Nordisk’s semaglutide widely used in GLP-1 therapy expired in India, ending its monopoly and enabling the entry of cheaper generic versions.

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About (Glucagon-Like Peptide-1 (GLP-1) Therapy

• GLP-1 (Glucagon-Like Peptide-1) therapy refers to the use of incretin-based drugs that mimic the natural GLP-1 hormone to manage type-2 diabetes and obesity.
  • Incretin-based drugs are a class of medications for type 2 diabetes
• Working Mechanism: These drugs act by enhancing glucose-dependent insulin secretion, suppressing glucagon release, delaying gastric emptying, and reducing appetite, thereby improving glycaemic control and promoting weight loss.
• Initially developed for diabetes management, GLP-1 therapy has gained prominence as an effective pharmacological intervention for obesity and metabolic syndrome.
• It is particularly relevant in the Indian context due to the high prevalence of insulin resistance and the “thin-fat phenotype.”
  

What are GLP-1 Drugs?

• GLP-1 (Glucagon-Like Peptide-1 agonist) drugs are prescription medications used to treat type 2 diabetes and obesity.
• For Example: Semaglutide injection, Tirzepatide, Dulaglutide

• The first GLP-1 medication was approved by the United States’ Food & Drug Administration in 2005.
• Prescription Guideline: In India, GLP-1 drugs can only be prescribed by endocrinologists, internal medicine specialists, and cardiologists.
  • They cannot be purchased over the counter.
• They are included in the WHO Essential Medicines List for diabetes management.
• Regulatory Regime: To ensure ethical pharmaceutical practices in the supply chain of GLP-1, the Drug Controller General of India has intensified its regulatory surveillance against the drug’s unauthorised sale and promotion. 

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Implications of Semaglutide Patent Expiry

• Improved affordability: Entry of generics has significantly reduced prices, making GLP-1 therapy accessible to a larger population.
• Enhanced accessibility: Wider availability across India, especially benefiting middle- and lower-income groups.
• Increased market competition: Multiple pharmaceutical players entering the segment, leading to innovation and price efficiency.
• Boost to public health outcomes: Greater access can aid in tackling the rising burden of obesity, diabetes, and related metabolic disorders.
• Regulatory challenges: Increased risk of misuse, over-prescription, and misleading advertisements necessitating stricter oversight.
• Healthcare system impact: Potential reduction in long-term disease burden and associated healthcare costs.
• Shift in treatment landscape: Strengthens pharmacological management of obesity, bridging the gap between lifestyle changes and bariatric surgery.

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